Dear Dr. Susan,
During a routine pelvic exam, I learned that I have a uterine fibroid tumor. It's about the size of a lemon, but thankfully, it's benign. My doctor is recommending that I have a hysterectomy.
I'm 42. What should I do?
Dear Cynthia, I'm glad that you wrote and that I have the opportunity to revisit this problem, because it's such a common one. In fact, 30-40 percent of women develop fibroids by age 50.
However, fibroids rarely cause symptoms, so they're often overlooked. (Try this Fibroid Tumor Quiz for a self-assessment.)Their growth is triggered by estrogen dominance, which refers to the body favoring the production of estrogen over progesterone. Since estrogen is a growth-stimulating hormone, it can trigger the growth of fibroids.
This is a common hormonal imbalance during perimenopause, and fibroids often disappear on their own after menopause. The problem with fibroids occurs when they get big enough or numerous enough to cause pain or increased bleeding during or between periods.
Some women also experience more frequent urination or changes in bowel habits because of the enlarged fibroids pressing against their bladder or colon.
These symptoms most often occur in women who tend to put their health on the back burner and don't eat right, exercise, reduce stress, or sleep well. That's when fibroids become abnormally severe. Many doctors recommend a hysterectomy to remove fibroids and prevent new ones from forming—after all, if you don't have a uterus, you can't have uterine fibroids.
But hysterectomies can cause so many other problems in the long term, such as loss of sex drive, that I truly believe that they should be reserved only for extremely severe cases that cannot be resolved with any other treatments.
Fortunately, there are several ways to safely, naturally, and effectively deal with uterine fibroids without ever needing to resort to major surgery.
My "Farewell to Fibroids" Plan Many women have come to me for second opinions after their primary doctors diagnosed them with fibroids and recommended surgery.
Of those willing to postpone surgery for six months or more to let my natural program rebalance their hormones, most of them improved so much that they cancelled their surgery and never looked back.
Cynthia, I am hoping you'll also give this program a try so that you can avoid surgery.
1. Eat for hormonal balance. (You can read this blog on herbs for regulating hormones.)
One key to bringing estrogen levels back into balance is to avoid foods that stimulate estrogen production, such as alcohol, sugar, and saturated fats.
Let your meals revolve around phytoestrogens—which, as you know from reading this month's lead article, are substances that are chemically and functionally similar to a woman's own natural estrogen, except that natural plant estrogens are much weaker and less potent.
Phytoestrogens soften estrogen's effects. Fibroid tissue is studded with estrogen receptors, and phytoestrogens bind to those receptors, displacing the more potent estrogen.
Colorful fruits and vegetables, whole grains such as buckwheat, ground flaxseed, and soy products are great phytoestrogen sources that are also rich in the vitamins and minerals needed to balance hormones, strengthen capillaries, and reduce uterine bleeding.
As for phytoestrogen supplements, I recommend 50-100 mg of soy isoflavones, 4-6 tablespoons of ground flaxseed, or 700-3,000 mg of bioflavonoids taken in divided doses.
2. Use supplements to help your fibroids heal and resolve. I start my patients on a top-quality, broad-spectrum multinutrient that contains at least 50 mg of B-complex vitamins, 500 mg of buffered vitamin C, 400 IU of vitamin E, 700 mg of calcium, and 350 mg of magnesium every day.
These nutrients help support the liver's ability to metabolize estrogen, block its fibroid-stimulating effects, maintain healthy uterine muscle tone, and help reestablish healthy hormonal balance. 3. Add nutrients that have special effects for the uterus and the hormones.
► Ground flaxseed is rich in lignans, a significant phytoestrogen source. As mentioned above, take 4-6 tablespoons daily.
► N-acetyl cysteine (NAC) normalizes the ovarian cycle, boosting natural progesterone levels to reestablish estrogen balance. I recommend 1,200 mg daily.
► Vitex (chaste tree berry) contains at least three phytoestrogens that block estrogen from its receptors and significantly help bring estrogen and progesterone into balance. It also helps to promote healthy ovulation, which is necessary for progesterone production.
I recommend 225 mg per day of a standardized product.
4. Slim down with exercise. Excess body fat is a significant site of estrogen manufacture in your body, and it tends to sustain estrogen dominance. If you're overweight, I recommend exercising for an hour a day, at least five days a week. Of course, regardless of your weight, it's important to exercise.
A recent study found that women who exercise regularly are significantly less likely to have fibroids that grow large enough to cause problems (American Journal of Epidemiology).
5. Supplement with progesterone.
The late John Lee, MD, pioneered the use of natural progesterone to reverse estrogen dominance.
ProgesterAll cream meets his strict guidelines. The dose is 1/8 teaspoon to 1/4 teaspoon massaged once or twice daily into your face, neck, inner thighs, or the palms of your hands. Women who are still menstruating should use the cream from day 14 to day 28 of their cycle.
Menopausal women not taking estrogen may use progesterone for three weeks each month. ProgesterAll is available at www.progesterall.com.
If you are interested in exploring other options besides hysterectomy, two experimental nonsurgical procedures are gaining popularity. Because they're new, there's relatively little data on their safety and effective-ness, and neither procedure will keep fibroids from growing back. With that said, they may still be a better option than a hysterectomy, so it's worth at least a discussion with your doctor.
Uterine artery embolization is one option. With this procedure, synthetic "clots" are injected into the vessels that feed your fibroids to cut off their blood supply.
Adverse effects, including vaginal odor, pain, cramp-ing, damage to the uterine lining, and adhesions, are worse with embolization than with laparoscopic fibroid removal. This procedure is not recommended if you plan to get pregnant in the future (Journal of Obstetrics and Gynaecology Research).
The second option is high-intensity focused ultra-sound (HIFU). In HIFU, strong ultrasound waves "cook" fibroid tissue while you lie sedated in an MRI tube. For more information, visit www.uterine-fibroids.org.
Please give this program a try, Cynthia. Within six months, I'm confident that you'll see significant results! ■
Love, Dr Susan!
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